CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Tillamook

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $845
Cash Discount Price: $831
vs. Medicare Baseline: 7.91x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Tillamook is $845. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $831. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.91x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$831

Average discount available for prompt cash payment at this facility.

Insurance Median

$845

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $831 (778%)

Insurance Median: $845 (791%)

Cash: $831 (778% of Medicare)

Ins. Median: $845 (791% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 791% of the Medicare baseline (a markup of 691%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$33 - $1,643	31%
Aetna	$39 - $1,608	37%
Moda Health Plan - All Plans	$40 - $813	37%
Medicare (plans)	$41 - $813	38%
Sterling Life - All Plans	$41 - $845	38%
Devoted Health	$42 - $878	39%
Blue Cross Blue Shield	$45 - $1,504	42%
Hvhs Mcare - All Plans	$47 - $821	44%
Ods Health Plan - All Other Plans	$92 - $1,677	86%
Pacificsource - All Plans	$116 - $1,660	109%
Lifewise - All Plans	$272 - $1,560	255%
Ah Employee Health Plan - All Plans	$283 - $1,625	265%
First Choice Health- All Plans	$283 - $1,625	265%
Health Net - All Plans	$283 - $1,625	265%
Providence Preferred - All Plans	$295 - $1,694	276%
Workers Comp	$302 - $1,729	283%
Cigna	$1,462 - $1,643	1369%
Phcs Preferred - All Plans	$1,462 - $1,643	1369%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $831.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tillamook is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.